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目的:探讨后腹腔镜手术切除巨大(直径≥6cm)肾上腺肿瘤的可行性。方法:对15例巨大肾上腺肿瘤患者进行后腹腔镜切除手术,左侧9例,右侧6例,肿瘤大小6cm×4cm×3cm~11cm×9cm×9cm,平均7.3cm×6.2cm×4.8cm。结果:11例成功行后腹腔镜手术切除,中转开放手术4例。术后2~3d拔除伤口引流管,3~5d下床活动,恢复顺利,无并发症。术后1~5年患者随访未发现异常。病理报告肾上腺囊肿3例,嗜铬细胞瘤3例,神经节瘤4例,皮质癌2例,神经鞘瘤1例,髓性脂肪瘤1例,肾上腺血肿1例。结论:巨大肾上腺肿瘤可以行后腹腔镜手术切除,但应在具有熟练的腹腔镜操作技术的条件下逐步开展。
Objective: To investigate the feasibility of retroperitoneal laparoscopic resection of huge (6cm in diameter) adrenal tumors. Methods: Fifteen patients with giant adrenal tumors underwent laparoscopic resection. There were 9 cases on the left and 6 cases on the right. The size of the tumor was 6cm × 4cm × 3cm ~ 11cm × 9cm × 9cm with an average of 7.3cm × 6.2cm × 4.8cm. Results: 11 cases underwent laparoscopic resection and 4 cases underwent open surgery. 2 ~ 3d after surgery to remove the wound drainage tube, 3 ~ 5d out of bed activity, recovery smoothly, no complications. 1 to 5 years after follow-up was found no abnormalities. Pathology report Adrenal cyst in 3 cases, pheochromocytoma in 3 cases, gangliosus in 4 cases, cortical carcinoma in 2 cases, schwannoma in 1 case, myeloma, 1 case of adrenal hematoma in 1 case. CONCLUSIONS: Giant adrenal tumors can be removed by retroperitoneal laparoscopic surgery, but should progressively be performed with a skilled laparoscopic technique.